Short Communication

Magnesium and Thiazide Diuretics

Author: Uwe Gröber

Thiazide diuretics are an FDA-approved class of drugs that inhibit reabsorption of luminal sodium in the distal convoluted tubule of the nephron. They have been used for the treatment of hypertension. Hypertension guidelines have underscored the importance of thiazide diuretics for all patients, but particularly for those with salt-sensitive and resistant hypertension. Thiazide diuretics are associated with a decrease of serum magnesium levels. Whereby the drug-induced magnesium depletion is be more severe in the elderly. Hypomagnesemia occurs more often in the elderly, and in those receiving continuous high-those diuretic therapy which may increase cardiovascular morbidity and mortality. Subclinical magnesium deficiency is a principal driver of cardiovascular diseases such as arrhythmias, arterial calcifications, atherosclerosis, heart failure, hypertension, and/or thrombosis. Hypertensive patients on long-term treatment with thiazide diuretics should therefore be monitored for magnesium deficiency, particularly those with additive risk factors, such as age > 60, hydrochlorothiazide doses ≥ 25 mg/day, insulin resistance, cardiovascular diseases (e.g. hypertension, arrhythmias), inadequate dietary intake, secondary aldosteronism and kidney dysfunction